Urticaria may be the only cutaneous manifestation of a leukocytoclastic vasculitis. We have studied nine patients with urticarial vasculitis.The spectrum ranged from limited cutaneous disease (six cases) to severe systemic disease with renal failure (one case). The individual urticarial lesions were of long duration (over 4h) in all patients and in seven cases an ecchymotic stain was left when the urticaria resolved. All patients complained of moderate to severe pruritus. Associated findings included arthralgia (two cases), fever (one case) and glomerulonephritis (one case), but none had neurological disease, abdominal pain or arthritis. Therapy was difficult in seven patients, and these cases were controlled only with systemic corticosteroids. This disorder falls within the larger group of vasculitides. It is distinguished only by its skin lesions, which cannot always be distinguished clinically from common urticaria.